In 2024-2025, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) delivered a major green‑infrastructure initiative across its estate: planting more than 400 mature native trees across six NHS sites.

This ambitious project forms part of CNTW’s commitment to sustainability and aligns with the NHS target of achieving net zero by 2040. Through partnership with NHS Forests and the use of detailed Biodiversity Baseline Assessments, CNTW has implemented a model of nature recovery that is evidence‑based, clinically relevant, and scalable across the wider NHS.

The challenge

The Trust, like many across the region, faced:

• Low baseline biodiversity in key sites due to frequent mowing, limited habitat diversity and the presence of non‑native species.
• Increasing climate pressures, including flooding risks at sites such as Hopewood Park.
• A need to enhance patient and staff environments, recognising the growing evidence linking access to nature with improved mental health, recovery and workplace wellbeing.
• Operational and sustainability pressures, with the NHS required to reduce carbon emissions, adapt to climate impacts, and demonstrate leadership in environmental stewardship.

These issues impact not only the health of the natural environment, but also patient care, staff experience, and long‑term operational resilience.

The solution: large‑scale native tree planting

CNTW’s response was a coordinated, multi‑site programme of tree planting, guided by ecological evidence and designed to create long‑term environmental value.

Key actions delivered

• 400+ mature trees planted (1.5-3 metres), including oak, birch, alder, cherry and yew.
• Strategic planting locations chosen to improve habitat quality, strengthen biodiversity, and create therapeutic green spaces for patients and staff.
• Flood‑resilient design at Hopewood Park, using deep‑rooted native species to stabilise soils and intercept rainfall.
• Staff involvement in planting and site improvement, building environmental awareness and community pride.
• Evidence‑led decisions using DEFRA’s Biodiversity Metric Tool and the DAFOR scale to assess starting conditions and target interventions.

This systematic approach ensures improvements are measurable, meaningful and aligned with national Biodiversity Net Gain requirements.

The impact

1. Environmental impact: improving biodiversity and climate resilience

Extensive baseline assessments showed that many CNTW sites had poor to moderate habitat condition, with grassland heavily mown and non‑native species limiting ecological diversity.

Through targeted planting:

• All sites saw a net increase in biodiversity.
• St Nicholas Hospital and Hopewood Park achieved a 17.5% increase in habitat units.
• Native trees improved habitat structure, food sources and ecological resilience.
• Updated grassland management is now supporting a wider range of species.
• Trees contribute to carbon sequestration, flood mitigation and reduced urban heat impacts.

2. Social value: enhancing wellbeing and community connection

The project created greener, more restorative environments, supporting:

• Patient wellbeing – natural settings promote recovery, reduce stress and improve mental health.
• Staff morale and connection to place – planting days and involvement in environmental projects foster engagement and purpose.
• Community value – greener NHS sites contribute to local biodiversity and public wellbeing.

3. Organisational value: leadership in sustainability

This project strengthens CNTW’s role as a regional and national leader by:

• Demonstrating tangible progress toward NHS net zero goals.
• Showcasing an approach that can be replicated by other trusts.
• Embedding sustainability into estates planning, operations and staff engagement.
• Producing clear, measurable ecological gains that support compliance with national biodiversity policies.

What’s needed to scale and sustain the impact

While enthusiasm among staff is strong, several system‑level challenges must be addressed to maintain and expand this work:

Key barriers

• Lack of dedicated funding for biodiversity, meaning reliance on short‑term or external grant sources.
• Limited maintenance capacity – many trusts depend on contracted grounds teams with fixed specifications, limiting flexibility to care for new plantings.
• Variable executive sponsorship, affecting how quickly and confidently sites can implement environmental improvements.

To continue this progress, the following enablers are essential:

• Long‑term resource and funding pathways for biodiversity and green space development.
• Improved visibility and integration of biodiversity within wider estates and sustainability strategies.
• Process changes that allow contractors to maintain biodiverse areas appropriately.

Executive ask

To strengthen and scale this work across the region, CNTW is seeking:

• Executive endorsement and sponsorship, recognising the significant clinical, environmental and organisational benefits of biodiversity improvements.
• Inclusion of biodiversity actions in national and ICB Green Plan guidance, ensuring trusts receive permission and policy backing to invest in nature recovery.

A model for a greener, healthier NHS

CNTW’s NHS Forests Tree Planting Project shows what is possible when evidence, partnership and staff engagement come together. By transforming NHS sites into thriving natural spaces, the Trust is improving biodiversity, supporting patient recovery and delivering on long‑term sustainability commitments.

This project is not just about planting trees – it’s about planting the foundations of a healthier, more resilient future for our patients, staff and communities.